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There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.

PURPOSE

The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.

METHOD

A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.

RESULTS

When measuring coping as a daily process relating to the specific stressful situation, different coping pocess patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.

CONCLUSIONS

Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

Aims: The aim of this study was to illustrate how the choice of gait measure could affect the statistical analysis of data and the resulting clinical conclusions. Methodology: A descriptive design in which the results from different tests from 10 patients with normal pressure hydrocephalus illustrates the potential to generate different clinical conclusions. Major findings and principal conclusion: The results illustrate how the choice of measure can affect the statistical results and the clinical interpretation of a study. It is possible to have the paradoxical situation in which one group has a better walking ability if the variable speed is used but the other group has a better walking ability if the variable time is used. An important message is that the choice of measurement and the transformation of data are not primarily statistical issues. If the statistical results are to be useful for clinical decisions, the variables used must be directly related to the utility for the subjects. An understanding of the clinical relevance of different outcomes is required. The distinction between when numbers are purely descriptive and when numbers represent a valuation is subtle and difficult to comprehend.

Most sports have to change their rules and scoring systems once in a while to adapt to external changes or improve the quality of their sport. The driving force behind many changes has been an attempt to make the games more exciting and suitable for television broadcasting.

For example, in April 2009, the World Squash Federation changed the rules in squash so points are awarded in every rally (ball played), compared to the traditional rules in which players only could score a point in their own serve.

Background: Prior pilot studies support the use of antiviral medications with topical corticosteroids for herpes simplex labialis (HSL). ME-609 (Xerese, Xerclear) is a combination of 5% acyclovir and 1% hydrocortisone developed for the topical treatment of HSL. Objectives: The primary study end point was the prevention of ulcerative HSL lesions. Methods: In all, 2437 patients with a history of HSL were randomized to self-initiate treatment with ME-609, 5% acyclovir in ME-609 vehicle, or ME-609 vehicle (placebo) at the earliest sign of a cold sore recurrence. Cream was applied 5 times/d for 5 days. A total of 1443 patients experienced a recurrence and initiated treatment with ME-609 (n = 601), acyclovir (n = 610), or placebo (n = 232). Results: Of patients receiving ME-609, 42% did not develop an ulcerative lesion compared with 35% of patients receiving acyclovir in ME-609 vehicle (P = .014) and 26% of patients receiving placebo (P < .0001). In patients with ulcerative lesions, healing times were reduced in the ME-609 and acyclovir groups compared with placebo (P < .01 for both). The cumulative lesion area for all lesions was reduced 50% in patients receiving ME-609 compared with the placebo group (P < .0001). There were no differences among groups in the number of patients with positive herpes simplex virus cultures. The side-effect profile was similar among treatments. Limitations: The study did not contain a group treated with a topical corticosteroid alone. Conclusions: ME-609 prevented progression of cold sores to ulcerative lesions and significantly reduced the cumulative lesion area compared with acyclovir and placebo. ME-609 treatment offers additional therapeutic benefit compared with therapy with topical acyclovir alone. (J Am Acad Dermatol 2011;64:696-705.)